A rapidly enlarging neck mass: the role of the sitting position in fiberoptic bronchoscopy for difficult intubation.
Difficult airway management is a dilemma for any anesthesiologist. Although practice guidelines and algorithms may help in such situations, the anesthesiologist's judgment and vigilance remain the primary means to save lives. In the following case, we encountered an acutely enlarging thyroid mass that was compromising the airway. This huge neck mass precluded tracheostomy under local anesthesia, and the patient could breathe only in the sitting position. Therefore, there were few safe strategies for airway management for general anesthesia. We reiterate the role of awake fiberoptic intubation in such circumstances.
Dabbagh
Ali
A
Department of Anesthesiology and Anesthesia Research Center, Shahid Beheshti University, M.C. Tehran, Iran. alidabbagh@yahoo.com
Mobasseri
Naseraddin
N
Elyasi
Hedayatollah
H
Gharaei
Babak
B
Fathololumi
Mohammadreza
M
Ghasemi
Mahshid
M
Chamkhale
Iman Bandarchi
IB
D018263:Adenocarcinoma, Follicular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D001999:Bronchoscopy / Q000379:methods* / Q000592:standards*; D018450:Disease Progression; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology / Q000379:methods / Q000592:standards; D006801:Humans; D007440:Intubation / Q000379:methods* / Q000592:standards; D009333:Neck / Q000033:anatomy & histology*; D011187:Posture; D016683:Supine Position; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome